Cardiopulmonary resuscitation has not fulfilled its original expectations, and the prognosis for patients remaining in cardiac arrest more than ten minutes remains poor (Becker AB, Ann Emerg Med, 20:355 (1991)). Indeed, cardiopulmonary resuscitation has recently been termed a "spectacular failure" in which only a small minority of patients have been successfully resuscitated (Barsan WG, JAMA, 265:3115-3118 (1991)). Standard advanced cardiac life support (ACLS) has only limited efficacy after the first few minutes of cardiac arrest. Studies in animal models have shown that vital organ blood flow, and thus oxygen delivery, during CPR is poor (Ditchey RV, et al, Circ, 66:297-302(1982); Ditchey RV et al, Cardiovasc Res, 19:419-425 (1985); and Taylor RB, et al, Resuscitation, 16:107-118(1988)). Indeed, CPR generally provides only a small fraction of normal oxygen supply to the brain and heart, and even less to other organs. Recent human studies have confirmed that perfusion pressures, the driving force for organ blood flow, are inadequate in humans during CPR (Paradis NA, et al, Circ, 80:361-368 (1989); Paradis NA, et al, JAMA, 263:1106-1113 (1990); and Martin GB, et al, Ann Emerg Med, 15:125-130(1986)). High-dose epinephrine, open chest CPR, and cardiopulmonary bypass increase perfusion pressure (Paradis NA, et al, JAMA, 265:1139-1144 (1991); Martin GB, et al, Ann Emerg Med, 16:628-636 (1987); and Howard MA, et al, Ann Emerg Med, 15:664-665 (1986)). However, these are not effective in all patients, or require significant resources not generally available.
In an effort to find simple but effective methods to improve perfusion during CPR, a number of mechanical intravascular based therapies have been investigated. Among these are arterial and venous volume infusion and aortic occlusion (Gentile NT, et al, Crit Care Med, (1990) (in press); Abu-Nema T et al, Circ Shock, 24:55-62 (1988); Suzuki A et al, Jpn J Anesthesiol, 29:677-682 (1980); Spence PA, et al, J Surg Res, 49:217-221 (1990)); and Manning JE et al, Ann Emerg Med, 19:212 (1990). These techniques, however, have failed to improve outcome. Aortic counterpulsation may improve perfusion (Emerman CL, et al, Am J Emerg Med, 7:378-383 (1989)), but has the disadvantage of requiring complex equipment which limits its use. Simple balloon occlusion, with or without volume infusion, does not appear to be effective.
It is known to provide oxygenated fluorocarbon emulsions to transport oxygen to oxygen deprived brain tissue (see U.S. Pat. No. 4,927,623 to Long, Jr.). It is also known to provide a blood cardioplegic solution as a resuscitative fluid for reperfusion of patients with myocardial infarction (see U.S. Pat. No. 4,988,515 to Buckberg).
Balloon catheter devices and methods are known for directing blood toward the heart during spontaneous circulation (see, for example, U.S. Pat. Nos. 4,531,936 to Gordon; 4,804,358 to Karcher et al; 4,601,706 to Aillon; and 4,459,977 to Pizon et al) .